BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated pediatric emergence delirium (PAED) scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat (ENT) surgery...

Importance: Specialty emergency departments (EDs) provide a unique mechanism of health care delivery, but the value that they add to the medical system is not known. Evaluation of patient preferences to determine value can have a direct impact on resource allocation and direct-to-specialist care. Objective: To assess the feasibility of contingent valuation (CV) methodology using a willingness-to-pay (WTP) survey to evaluate specialty emergency services, in the context of an ophthalmology- and otolaryngology-specific ED...

OBJECTIVES: The etiopathogenesis of functional voice disorders (FVDs) is multifactorial. The purpose of this study was to analyze the severity of depression and anxiety, and the incidence of affective and anxiety disorders, in patients who presented different types of FVDs and were followed at the University Clinic of Otolaryngology. DESIGN: This is a cross-sectional study. METHODS: After ENT observation, 83 women were classified into three groups: psychogenic voice disorder (PVD = 39), primary muscle tension voice disorder (MTVD1 = 16), and secondary muscle tension voice disorder (MTVD2 = 28)...

We aim to translate the Glasgow benefit inventory (GBI) questionnaire into Arabic language and assess its reliability in scoring the benefit of patients after otolaryngology interventions. This is a pilot study of an ongoing prospective cohort study. The original GBI questionnaire was translated into Arabic language and back-translated into English by two different experts. The questionnaire was given to patients who were asked to fill it themselves. A group of consecutive adult patients were included in the study...

INTRODUCTION: The anterior epitympanum recess (AER) is a common place of the development of the cholesteatoma, which is why removal of the matrix from this area plays a key role in the surgical treatment of chronic otitis media. AIM: To evaluate the intraoperative visibility of AER in endoscopic optics in comparison to microscopic optics and to determine the prevalence of cholesteatoma in various types of construction of the AER. Study design: retrospective analysis of intraoperative search...

INTRODUCTION: Sensorineural emergencies (SNE) are rare clinical situations. Few patients consult early explaining subsequent difficulty in having accurate data and management. Three clinical conditions are considered SNE in otolaryngology; they include sudden sensorineural hearing loss (SSHL), Bell's palsy and acute vertigo. There is very little data available on sensorineural emergencies in our setting. The aim of this study was to provide preliminary data on the management of Ear Nose and Throat (ENT) sensorineural emergency cases in Yaoundé Reference Hospital...

Importance: To date, an otolaryngology-specific morbidity and mortality (M&M) conference has never been reported or evaluated. Objective: To propose a novel otolaryngology-specific M&M format and to assess its success using a validated assessment tool. Design, Setting, and Participants: Preintervention and postintervention cohort study spanning 14 months (September 2014 to November 2015), with 32 faculty, residents, and medical students attending the department of otolaryngology M&M conference, conducted at the the San Antonio Uniformed Services Health Education Consortium...

OBJECTIVES: Conservative management for retropharyngeal abscesses <2 cm is now a first line option. It is unclear if conservative management can be used to manage larger abscesses without increased morbidity and mortality. STUDY DESIGN: A prospective case series was performed from 2012 to 2015 by the Otolaryngology department of the San Fernando General Hospital involving pediatric patients who presented with retropharyngeal abscesses. All patients were initially treated with antibiotics alone...

INTRODUCTION: With the advent of improved neonatal and pediatric intensive care management, tracheostomy is increasingly performed in children requiring prolonged ventilation. Even though tracheostomy is generally a safe procedure, there remains mortality and morbidity associated with it. OBJECTIVE: We report a rare complication of a tracheostomy tube resulting in extensive erosion and posterior tracheal false pouch secondary to a large tracheostomy tube and high positive end expiratory pressure in a 12-month-old infant...

This American Head and Neck Society (AHNS) consensus statement focuses on the detection and management of recurrent thyroid cancer. This document describes the radiologic approach to defining structural recurrent disease and the operative and nonoperative rationale in addressing identified structural disease to create equipoise in the personalized treatment strategy for the patient. The recommendations of this AHNS multidisciplinary consensus panel of the American Head and Neck Society are intended to help guide all multidisciplinary clinicians who diagnose or manage adult patients with thyroid cancer...

OBJECTIVE: This study aimed to evaluate the activity of paediatric otolaryngology services required for children with Down's syndrome in a tertiary referral centre. METHODS: A review of the paediatric otolaryngology input for children with Down's syndrome was performed; data were obtained from the coding department for a two-year period and compared with other surgical specialties. RESULTS: Between June 2011 and May 2013, 106 otolaryngology procedures were performed on children with Down's syndrome...

AIMS: CSF leaks are not uncommon after a base of skull fracture. Currently there is no standardised algorithm for the investigation and management of post-traumatic CSF leaks. In this paper we aim to provide an evidence-based framework for managing post-traumatic CSF leaks. METHODS: We searched the English literature over the past 45 years using CINAHL, EMBASE and MEDLINE for the terms (1) post-traumatic CSF leaks or fistulas, and (2) basilar or base of skull fractures, but excluded papers on post-operative and non-traumatic CSF leaks, and papers on paediatric post- traumatic CSF leaks...

BACKGROUND: Herpes zoster (HZ, shingles) is a frequent medical condition which may severely impact the quality of life of affected patients. Different therapeutic approaches to treat acute HZ are available. OBJECTIVE: The aim of this European project was the elaboration of a consensus-based guideline on the management of patients who present with HZ, considering different patient populations and different localisations. This interdisciplinary guideline aims at an improvement of the outcomes of the acute HZ management concerning disease duration, acute pain and quality of life of the affected patients and at a reduction of the incidence of PHN and other complications...

OBJECTIVES/HYPOTHESIS: The number of trained otolaryngologists available is insufficient to supply current and projected US health care needs. The goal of this study was to assess available databases and present accurate data on the current otolaryngology workforce, examine methods for prediction of future health care needs, and explore potential issues with forecasting methods and policy implementation based on these predictions. STUDY DESIGN: Retrospective analysis of research databases, public use files, and claims data...

Chronic rhinosinusitis (CRS) symptoms can significantly reduce quality of life. The Sinonasal Outcome Test-22 (SNOT-22) is frequently used to assess this disease-specific quality of life, although it has not been translated into Thai language. We translated the original SNOT-22 questionnaire to Thai using forward-backward technique, and validated it in CRS patients [n = 229, mean age of 52.6 (SD = 15.9)] recruited at outpatient Otolaryngology clinic, Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand...

BACKGROUND: Grommet insertion is a common procedure in children. A lengthy otolaryngology follow-up can have an adverse impact on clinic waiting times, new patient appointment availability, and pecuniary disadvantage for the hospital. OBJECTIVE OF REVIEW: To consolidate research and opinion concerning follow-up care following grommet insertion in a pediatric population. SEARCH STRATEGY: The literature between January 1990 and September 2015 was searched on MEDLINE (Ovid), Google Scholar, PubMed and Web of Science databases...

Importance: Injury of the recurrent laryngeal nerve (RLN) is one of the most serious complications of thyroid surgery. Intraoperative neuromonitoring (IONM) has been introduced to verify RLN function integrity and may be a helpful adjunct in nerve dissection. Objective: To determine whether the use of IONM can reduce the incidence of RLN injury in patients undergoing total thyroidectomy. Design, Setting, and Participants: This cohort study included 2556 patients who underwent total thyroidectomy between January 2002 and December 2012 in the Department of Otolaryngology-Head and Neck Surgery of Venizeleio General Hospital, Heraklion, Greece...

INTRODUCTION: Metabolic activity of the inner ear is very intense, and makes it sensitive to changes in the body homeostasis. This study involves a group of patients with inner ear disorders related to carbohydrate metabolism disturbances, including hearing loss, tinnitus, dizziness, and episodes of vertigo. OBJECTIVES: To describe the symptoms of metabolic inner ear disorders and the examinations required to establish diagnoses. These symptoms are often the first to allow for an early diagnosis of metabolic disorders and diabetes...